Individual
CHRISTOPHER TYLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CADC 1
Contact information
Practice address
356 NE BEACON DR, GRANTS PASS, OR 97526-3815
(541) 474-1033
Mailing address
PO BOX 1121, ROSEBURG, OR 97470-0254
(541) 672-2691
(541) 734-2410
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
—
—
Other
Enumeration date
08/09/2018
Last updated
02/20/2024
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